RESUMOIntrodução: A qualidade da relação pais-filho influencia o desenvolvimento do sistema fisiológico de regulação do stress da criança. Exploraram-se eventuais associações entre estratégias de vinculação e o cortisol e a hormona estimulante da tiróide, respectivamente como possíveis mediador e variável interveniente na relação mãe-filho, na criança obesa. Material e Métodos: Foi recrutada na Consulta de Obesidade uma amostra de conveniência de 83 crianças obesas com 10,9 (1,8) anos de idade (46 rapazes). A obesidade foi definida pelo percentil do índice de massa corporal para idade e género e os biomarcadores neuroendócrinos foram medidos pelos métodos de rotina. As estratégias de vinculação foram avaliadas através dos questionários (IACA) para pais e crianças. O funcionamento familiar foi classificado através do preenchimento pelos pais do FACES-III. Foram analisados modelos multivariáveis de regressão linear. Resultados: As estratégias de vinculação insegura do tipo evitante (tipo A) apresentaram uma associação significativa positiva com os níveis de hormona estimulante da tiróide e negativa com os níveis de cortisol (R 2 = 0,352). As estratégias de vinculação segura (tipo B) associaram-se positivamente ao hipotiroidismo e ao percentil de índice de massa corporal, ambas com significado estatístico (R 2 = 0,541). As estratégias de vinculação insegura apresentaram alguma evidência de associação positiva com a hormona estimulante da tiróide (R2 = 0,250). Discussão: Estes achados sugerem a existência de factores comuns na regulação dos eixos hipotálamo-hipófise-adrenal e hipotála-mo-hipófise-tiróide. Os processos envolvidos no desenvolvimento das estratégias de vinculação do tipo A parecem associar-se aos mecanismos regulatórios do eixo HPA. Conclusão: Diferentes estratégias de vinculação estão associadas a diferentes padrões metabólicos em crianças obesas. Desconhece-se qual a sua contribuição para o desenvolvimento e diferenciação da abordagem terapêutica. Palavras-chave: Apego ao Objecto; Criança; Obesidade Pediátrica; Sistema Hipotálamo-Hipofisário; Sistema Hipófise-Suprarrenal; Stress Psicológico; Tireotropina. ABSTRACTIntroduction: Quality of the parent-infant relationship influences the mechanisms of development of the child's physiological stress regulation. This study explored associations between attachment strategies and both cortisol and thyroid stimulating hormone, hypothesized to be respectively a potential mediator and a potential intervening variable of the mother-child relationship in obese children. Material and Methods:A sample of 83 obese children (46 boys), aged 10.9 (1.8) years was recruited from a child obesity clinic. Obesity was defined by body mass index percentile adjusted for age and sex. Metabolic biomarkers were measured by routine methods. Attachment strategies were assessed with self and parent-report questionnaires. Family functioning was assessed with parent-reported questionnaires (FACES-III). Multivariate linear regression analyses were performed. Results: Type A, avoidant at...

Home-based models represent one of the solutions to respond to the poor accessibility of pulmonary rehabilitation (PR) services in patients with chronic respiratory disease (CRD). The main goal of this protocol is to present the implementation of the first nationwide home-based PR program—reabilitAR—in Portugal and the strategies to assess its benefits in patients with CRD. The program consists of 2 phases: a 12-week intensive phase and a 40-week maintenance phase (total: 52 weeks, 1 year). The intervention in both phases is composed of presential home visits and phone-call follow ups, including exercise training and the self-management educational program Living Well with COPD. Dyspnea, impact of the disease, emotional status, and level of dyspnea during activities of daily living are used as patient-reported outcomes measures. A one-minute sit-to-stand test is used as a functional outcome, and the number of steps as a measure of physical activity. To ensure safety, fall risk and the cognitive function are assessed. Data are collected at baseline, at 12 weeks, at 26 weeks and at 52 weeks. This is the first nationwide protocol on enhancing access to PR, providing appropriate responses to CRD patients’ needs through a structured and personalized home-based program in Portugal.

Depression and cancer are common co-morbidities. Depression is now conceptualized as a systemic disease of chronic inflammation; it has a well-known deleterious impact on the course and outcome of inflammatory-mediated medical illnesses. There are evidences that depression predicts cancer progression and mortality and that providing psychosocial support reduces depression, anxiety, and pain, and may increase survival time with cancer.To understand if depression can represent a risk factor for cancer incidence, progression and survival.A survey was made on depression as a risk factor for cancer; PubMed and ClinicalKey® databases were searched to identify studies and meta-analysis on the subject. The key words/expressions: "depression", "risk factor" and "cancer" were used.

This article's analysis builds up to the answer of how the draft AI Act presented by the Commission in April 2021 has strengthened the Parliament's long-standing call for a direct right of legislative initiative. After outlining the overall policy and institutional setting preceding both proposals, the article presents a comparative exercise between the Commission's proposal and the Parliament's legislative report on regulating the ethical aspects of AI to which the former is responding. It thereby concludes that the draft AI Act, albeit in its initial stages, already demonstrates the added value of granting the Parliament a direct right of legislative initiative, especially where the proposal draws significant inspiration from its unprecedented work on complex questions.